HEALTH CARE/Joan Retsinas

An Antidote to Government Fatigue

Thanks to endless debates (have we hit 200?) and lexicon-searches for who said what when, campaign-fatigue is endemic. Fortunately the November election will cure it.

The more troubling disease is government-fatigue: voters are sick not just of the campaign, but of government.

Government-fatigue seems intractable. Many Americans consider Uncle Sam at best inept, at worst malicious. Internationally, we are waging a war we cannot explain, much less win. Nationally, our solons are watching the economy plummet. The dollar is in free-fall. On health care, the number of uninsured creeps up. Taxpayers are paying more to fund a government that is helping us less.

As an antidote to the malaise, grab Charlatan by Pope Brock. Brock recounts the rise of Dr. John Brinkley, quack extraordinaire, who promised to invigorate aging bodies with the testicles of goats. Because goats are sexually vigorous, Dr. Brinkley inserted their glands into men  some women too. Americans and Europeans, including cynics like H.L. Mencken, bought the promise. Eventually Dr. Brinkley abandoned goats and switched to a just-as-good potion; indeed, depending upon your pocketbook, you could choose from several just-as-good potions. Dr. Brinkleys income soared with his popularity. He came close to being elected governor of Kansas as a write-in candidate. When he moved to Mexico, he set up a long-range radio station (border buster) that interspersed advertisements for his products, anecdotes about life, and country music. One feature, Medical Question Box, invited listeners to call in with their complaints. On the radio, hed recite a cure based on his potions. The pharmacists got a kickback. His income, and popularity, soared higher.

In the free-wheeling, laissez-faire America of the 1920s and 1930s, the rise of an entrepreneurial huckster was not surprising. Brinkley had competitors, all sprouting miracles. He simply sprouted his with more verve and greater savvy.

Brock has written a battle memoir: Dr. Brinkley versus the government. In tracing the downfall of Dr. Brinkley, Pope Brock recounts the fledgling power of government to protect the nations health.

In banning him and his products, the government erected barriers against quackery that persist. Today John Brinkley might be hawking get-rich schemes on cable, running infomercials, or selling predatory mortgagesa con artist, but not a medical con.

To alleviate government-fatigue, consider the governmental actions that protect us from a free-market medicine boondoggle.

Licensing of Physicians

In an unregulated marketplace, Dr. Brinkley flourished. Established physicians knew that he was a quack. Yet fervent opposition from the elitist American Medical Society only increased his populist appeal.

It was the state licensing boards who successfully argued that he was a danger to the public. When state boards pulled his licenses, he retreated to Mexico.

Regulation of Medical Advertising

Dr. Brinkley promised that his Ponce de Leon potions would make old men young. Thanks to federal regulations, pharmaceutical companies must refrain from grandiose promises. The glitzy advertisements for the nations pharmacopeia of drugs (including the erectile dysfunction drugs, todays successor to goat testicles) have disclaimers that disclose the risks. In magazines, the risks are clearly printed; on television, a voice-over recites them. That is the law.

Regulation of Pharmaceutical Products

Dr. Brinkley wouldnt tell a Congressional committee what was in his potions. (One potion had colored water.)

Todays potions can lower cholesterol, kill cancer cells, boost the immune system, increase potency, erase wrinkles. Name a disease: researchers are hunting a pharmaceutical miracle. But you know what is in the miracles. Every drug goes through exhaustive trials. And when drugs have been on the market and patients report adverse events, investigators review the drug. The Food and Drug Administration oversees that vetting.

A few generations ago, anybody who bought a medical diploma could hang out a shingle. Nobody regulated the claims of hucksters who lured desperate patients into paying for guaranteed cures. Nobody regulated the elixirs, the potions, the injections. The public could judge for itself. The government didnt meddle.

Without governmental protections, the successors of John Brinkley would be peddling their potions on cable, on the internet, on radio. If that seems fanciful, look at the unregulated subprime mortgage market, where brokers eager for fat commissions lured borrowers into signing up for mega-loans at rising rates that led straight to foreclosure, if not bankruptcy.

So when government-fatigue settles in, and you wonder what you are paying for, think of Dr. John Brinkley, who, in an era without government controls, duped Americans of their money, their health, sometimes their lives.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.